Sunday, September 17, 2017

60/60 for PE

The Bottom Line - September 15, 2017 - By David Slessor
"Clinical Question
In patients with suspected acute pulmonary embolism, do echo features of disturbed right ventricular ejection allow accurate diagnosis?...
The Bottom Line
  • In patients seen at a tertiary referral centre with a high pre-test probability of acute pulmonary embolism, the McConnell Sign had a very high positive likelihood ratio. In patients without previous cardiorespiratory disease the 60/60 sign also demonstrated a very high positive likelihood ratio. A negative McConnell or 60/60 sign added little diagnostic information
  • In patients presenting to the ED/ICU with a high probability of acute pulmonary embolism who cannot immediately undergo CT, I will use bedside echo to assess the 60/60 and McConnell’s signs. A positive test result will give me greater confidence for the diagnosis of acute pulmonary embolism, where as a negative result will neither help confirm or repute the diagnosis of acute pulmonary embolism"